Iron Sucrose

Introduction

Hematinic agent; a polynuclear iron (III)-hydroxide sucrose complex.

Uses for Iron Sucrose

Iron Deficiency Anemia in Patients with Chronic Kidney Disease

Treatment of iron deficiency anemia in patients with chronic kidney disease (CKD), including those who are undergoing dialysis (hemodialysis or peritoneal) and those who do not require dialysis.12345691112

In patients with CKD on hemodialysis, IV iron superior to orally administered iron in increasing hemoglobin concentrations and/or minimizing dosage of an erythropoiesis-stimulating agent (ESA); the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) guidelines state that the IV route of iron administration is preferred in such patients.6

Available data suggest that iron sucrose and sodium ferric gluconate may be associated less frequently with serious adverse effects (e.g., hypersensitivity reactions) than iron dextran.491516

Iron sucrose injection also used as iron maintenance therapy in children with dialysis-dependent (hemodialysis or peritoneal dialysis) or non-dialysis-dependent CKD.1 (See Pediatric Use under Cautions.)

Iron Sucrose Dosage and Administration

General

Although manufacturer makes no specific recommendations regarding test doses, test doses of iron sucrose (20–25 or 50 mg) have been administered in some patients.1101112 (See Sensitivity Reactions under Cautions.)

Ensure immediate availability of personnel trained to provide emergency treatment and appropriate agents for the treatment of a severe allergic or anaphylactic reaction when administering iron sucrose injection.1

Administration

IV Administration

For solution and drug compatibility information, see Compatibility under Stability.

Pediatric Patients

IV

Children ≥2 years of age: 0.5 mg/kg (not to exceed 100 mg per dose) every 2 weeks for 12 weeks; may administer undiluted by slow IV injection over 5 minutes or diluted in 25 mL of 0.9% sodium chloride injection over 5–60 minutes.1

IV

Children ≥2 years of age: 0.5 mg/kg (not to exceed 100 mg per dose) every 4 weeks for 12 weeks; may administer undiluted by slow IV injection over 5 minutes or diluted in 25 mL of 0.9% sodium chloride injection over 5–60 minutes.1

IV

Children ≥2 years of age: 0.5 mg/kg (not to exceed 100 mg per dose) every 4 weeks for 12 weeks; may administer undiluted by slow IV injection over 5 minutes or diluted in 25 mL of 0.9% sodium chloride injection over 5–60 minutes.1

Adults

Patients with Hemodialysis-dependent CKD

IV

100 mg by slow IV injection (over 2–5 minutes) or by IV infusion (diluted in a maximum of 100 mL of 0.9% sodium chloride injection and administered over at least 15 minutes) during each consecutive hemodialysis session.1 Administer early during dialysis procedure.1

Patients with Non-dialysis-dependent CKD

IV

200 mg by slow IV injection (over 2–5 minutes) or IV infusion (diluted in a maximum of 100 mL of 0.9% sodium chloride injection and administered over 15 minutes) for a total of 5 doses; administer the doses on 5 different occasions over a 14-day period.1

Also has been administered in a dosage of 500 mg by IV infusion (diluted in a maximum of 250 mL of 0.9% sodium chloride injection) on days 1 and 14; administer each dose over 3.5–4 hours.1

Patients with Peritoneal Dialysis-dependent CKD

IV

Administer a series of 3 doses, each dose spaced 14 days apart, over 28 days.1 For the first 2 doses, administer 300 mg by IV infusion (diluted in a maximum of 250 mL of 0.9% sodium chloride injection and administered over 1.5 hours); follow with a dose of 400 mg (diluted in a maximum of 250 mL of 0.9% sodium chloride injection and administered over 2.5 hours).1

Special Populations

Stability

Storage

Parenteral

Injection

When diluted with 0.9% sodium chloride injection at concentrations of 2–10 mg of elemental iron per mL and stored in a plastic syringe, stable for 7 days at controlled room temperature (25 ± 2°C) or under refrigeration (4 ± 2°C).1

When stored undiluted in a plastic syringe at a concentration of 20 mg of elemental iron per mL, stable for 7 days at 25 ± 2°C or 4 ± 2°C.1

When added to IV infusion bags containing 0.9% sodium chloride injection at concentrations of 1–2 mg of elemental iron per mL, stable for 7 days at 25 ± 2°C.1